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Abstract
Hemorrhoids, which remain one of the most common colorectal complaints, have been classified into three types: (1) internal, (2) external, and (3) internal-external (mixed). Currently, there are a variety of therapeutic options for hemorrhoids, and the severity of hemorrhoidal disease determines the proper therapy. Added to the present armamentarium of therapies is a uniquely designed suppository that is used primarily to treat internal and external hemorrhoids and also is used for the treatment of anal fissures. The Rectal Rocket, designed by compounding pharmacists Robert and Jerry Boudreaux, delivers lidocaine and hydrocortisone directly to the site of inflammation and heals injured tissue. In this interview, Robert Boudreaux, RPh, and his son, Douglas Boudreaux, PD, discuss the history, design, mode of action, and availability of this unique preparation.
"On Hemorrhoids
Having got the amis to protrude as much as possible, enrwith hot water, and then cut off the extremities of the hemorrhoids. But this medicine should be prepared beforehand, as an application to the wound: Having put urine into a bronze vessel, sprinkle upon the urine the flower of bronze calcined and finely triturated; then, when it is moistened, shake the vessel and dry in the sun. When it becomes dry, let it be scraped down and levigated, and apply with the finger to the part, and having oiled compresses, apply them, and bind a sponge above.1"
Hippocrates
c. 460 BC
Hemorrhoidal treatments have abounded since antiquity, and many of those therapies, like those prescribed by Hippocrates, seem far worse than the affliction. Fortunately, compounding pharmacists Robert, Jerry, and Douglas Boudreaux offer a better alternative: a 2-day treatment called the "Rectal Rocket." Ancient medical practitioners and their patients would have greatly appreciated this simple solution to a painful affliction first described in ancient Egyptian papyri.2 The types of treatment (surgical excision, outpatient nonsurgical treatment, and medical therapy) for this common anorectal disorder have changed little since the writings of Hippocrates,2 although a cure for hemorrhoids has been sought with persistence. Medical therapy was not the sole hope for relief from the itching and bleeding of these vascular lesions. Patients in the Middle Ages, for example, prayed (as do many today) for help with healthrelated matters, and the 7th-century Irish monk St. Fiacre became the...